Tag Archives: government IT

The dismembering of the Government Digital Service is underway, says Andrew Greenway, a former programme manager working on digital projects for the Cabinet Office. He now works as an independent consultant.

Paul Downey, GDS’s Technical Architect – who is described by former colleagues as a “legend” and “national treasure” – has left to join the Ministry of Housing, Communities and Local Government.

Downey is the latest in a long line of leading government technologists to leave GDS, which will confirm in the minds of many that Sir Humphrey has won the campaign to stop GDS interfering in the 100 year-old autonomy of individual government departments.

Cabinet Office minister Francis Maude and entrepreneur Martha Lane Fox set up GDS in 2011 to break down departmental silos and have a “single version of the truth” for everything that government touches.

Former prime minister David Cameron said the creation of GDS “is one of the great unsung triumphs of the last Parliament”

Downey helped departments to create new digital services. He represented GDS on the UK government Open Standards Board. Formerly he was BT’s Chief Web Services Architect.

In reply to Downey’s tweet announcing his departure, Stephen Foreshew-Cain, former Executive Director of GDS, tweeted, “When people talked about standing on the shoulders of giants, they were talking about you.”

Tom Loosemore, founder of GDS who, in 2012, wrote the Government Digital Strategy for GDS, also tweeted praise for Downey.

Loosemore left GDS in 2015 for the Co-op group. In an interview shortly after leaving, Loosemore said, “The shape of government needs to change … Businesses don’t run on siloed departments any more and neither should government.”

Liam Maxwell, National Technology Adviser at HM Government who used to be the government’s chief technology officer and who ran teams at GDS, tweeted,”You have been total inspiration to me and hundreds of others”.

Dismembering

Greenway said GDS retains people, prestige and power. “There is no question that the civil service is in a much stronger position on digital than it was six years ago. Some of the work going on in government, including the teams in GDS building digital platforms, remains world-leading”.

Despite bleeding skills elsewhere, GDS has not experienced a terminal brain drain, says Greenway. “Many of those who have stayed are doing a heroic job in trying circumstances.”

But he added that officials working on digital programmes in other departments describe the GDS team as well-meaning but increasingly peripheral.

It now looks as if the Department of Digital, Culture, Media and Sport will take over from GDS. But Greenway warns against replacing a weakened centre with diffuse departmental effort.

“The point of GDS was to have a single team that could act as the voice of users for government as a whole. To do that well, it needed a mandate covering data as well as design, operations and technology. It also had to have a clear mission. Increasingly, it has neither of these.

“The departmental shape of government gives no incentive for any non-central department to step in. It is a great shame that the two most well-placed advocates for an effective centre — the Treasury and Sir Jeremy Heywood — have proved unable or unwilling to stop the rot …

“The dismembering of GDS is underway.”

Comment

GDS was a great idea. But Sir Humphries tend not to like great ideas if they mean internal change. Permanent secretaries are appointed on the basis that they are a safe pair of hands. Safe in this context means three things:

talking daily of the need for large-scale “transformative” change while ensuring it doesn’t happen.

Thus, for the past few years, GDS professionals have found that top civil servants want central government departments to continue to be run as separate bureaucratic empires with their uniqueness and administrative traditions preserved.

GDS technologists, on the other hand, want to cut the costs of running Whitehall and the wider public sector while making it easier for the public to interact with government. This puts GDS at odds with Whitehall officials who believe that each departmental board knows best how to run its department.

In the long run GDS cannot win – because it was set up by politicians who wanted change but whose stewardship was temporary while the will to dismember GDS comes from the permanent secretariat who do not welcome change and have the power to resist it.

More’s the pity because taxpayers will continue to spend a fortune on preserving departmental silos and huge, unnecessarily-complex technology contracts.

“It is working,” said Work and Pensions secretary David Gauke in Manchester yesterday. He was referring to a plan to accelerate the rollout of Universal Credit from this month.

“I can confirm that the rollout will continue, and to the planned timetable,” he added.

But are civil servants giving Gauke – and each other – full and unexpurgated briefings on the state of the Universal Credit programme?

Last year, in a high-level DWP document that government lawyers asked a judge not to release for publication, a DWP director referred to

“a lack of candour and honesty throughout the [Universal Credit] programme.”

Senior civil servants were not passing bad news on the state of the Universal Credit IT programme even to each other.

The DWP document was dated several years after Iain Duncan-Smith, the original force behind the introduction of Universal Credit, found his internal DWP briefings on the state of the UC programme so inadequate – a “good news” culture prevailed – that he brought in his own external advisers – what he called his “red team”.

In 2013 the National Audit Office, in a report on Universal Credit, said a “good news” mentality within the DWP prevented problems being discussed.

If problems could not be discussed they could not be addressed.

Last year the Institute for Government, in a report on Universal Credit, said IT employees at the DWP’s Warrington offices burst into tears with relief when at last permitted – by external advisers – to talk openly about problems on the programme.

The Work and Pensions Committee has questioned why DWP ministers told MPs all was going well with the programme when it was well behind schedule and beset with problems.

The Public Accounts Committee called the DWP “evasive and selective” when it came to passing on information about the state of the Universal Credit programme.

Is there any reason to believe that the “fortress mentality” that the NAO referred to in its report on Universal Credit in 2013 is no longer present?

When David Gauke announced yesterday that he is continuing the rollout of Universal Credit, was he basing his decision on the full facts – or a “good news” version of it as told to him by the DWP?

Comment

David Gauke will have been given the “new minister” treatment when he joined the DWP on 11 June 2017.

“The first thing you’ve got to overcome when you walk through the door is that everybody is being almost far too nice to you,” said one of Gauke’s predecessors, Iain Duncan Smith. He was speaking in 2016 after leaving the DWP.

IDS was much criticised for assuring Parliament all was well with the Universal Credit IT programme when it wasn’t. But maybe he was right to point out that, when he joined the DWP, he found that the “biggest cultural barrier” was getting civil servants to be honest about difficulties.

“The Civil Service, legitimately, see it as their role to deliver on politicians’ policy demands and this can sometimes make them resistant to the idea that they should inform you early of problems,” said IDS.

It was IDS who told BBC’s Radio 4 Today programme in December 2013, that Universal Credit was on track.

“It’s on budget. It’s on budget. Some 6.5million people will be on the system by the end of 2017.”

In fact, fewer than 700,000 people are claiming Universal Credit, according to the latest DWP statistics.

DWP’s 30 years of a “good news” culture

In the past 30 years, it has been almost unknown for the DWP’s mandarins to concede that they have had serious problems with any of their major IT-based projects and programmes.

Perhaps it’s understandable, then, that Gauke apparently refuses to listen to critics and continues with the accelerated rollout of Universal Credit.

Would he have any idea that the Citizens Advice Bureau, in a carefully-researched report this year, said that some claimants are on the DWP’s “live service” (managed by large IT suppliers) which is “rarely updated” while other claimants are on a separate “full service” – what the CAB calls a “test and learn” system – which is still being designed?

Would Gauke know of the specific concerns of the all-party Work and Pensions Committee which wrote to the DWP earlier this year about Universal Credit decision makers being “overly reliant on information from [HMRC’s] Real-time information” even when there is “compelling evidence” that this data is incorrect?

Would Gauke have any reason to believe those who refer to regular computer breakdowns and inaccurate and inconsistent data?

In the DWP’s own document that it did not want published, the DWP director said that, internally, “people stopped sharing comments which could be interpreted as criticism of the Programme, even when those comments would be useful as part of something like an MPA [Major Projects Authority] review.”

Many staff believed the official line was ‘everything is fine’. Nobody wanted to be seen to contradict it.

All this suggests that the DWP will carry on much as before, regardless of external criticism. Individual ministers are accountable but they move on. Their jobs are temporary. It’s the permanent civil service that really matters when it comes to the implementation of Universal Credit.

But mandarins are neither elected nor effectively accountable.

NHS IT programme?

There may be some comparisons between Universal Credit and the NHS IT programme, the £10bn NPfIT.

A plethora of independent organisations and individuals expressed concerns about the NPfIT but minister after minister dismissed criticisms and continued the rollout. The NPfIT was dismantled many years later, in 2011. Billions was wasted.

Based on their civil service briefings, NPfIT ministers had no reason to believe the programme’s critics.

Universal Credit has more support than the NPfIT and the IT is generally welcomed, not shunned. But the Universal Credit rollout is clearly not in a position yet to be speeded up.

Whether Gauke will recognise this before his time is up at the DWP is another matter.

Like IDS, Stephen Crabb and Damian Green – all secretaries of state during the rollout of Universal Credit – Gauke will move on and his successor will get the “new minister” treatment.

The Register has an excellent piece by Kat Hall on how the Cabinet Office is losing its grip on Government departments.

Citing the annual report of the all-party Public Accounts Committee, Hall says there are issues where “departments repeatedly don’t do what they have been told or asked to do by the centre”.

An analysis by The Register found that

“government departments are winning significantly more exemptions to splash the cash on expensive IT projects since the departure of former Cabinet Office minister Francis “Mad Frankie” Maude last year”.

Chair of the Public Accounts Committee Meg Hillier said: “After my second year as Chair I am increasingly concerned about the long-term accountability of senior civil servants.

“The game of musical chairs starts as one Permanent Secretary moves on and they all change jobs in the system. And few are in post long enough to have a vested interest in the long-term aims of their department or a project.

“And there is the age-old tension between a department and central Whitehall through the Cabinet Office.”

Universal Credit and HMRC’s plans to overhaul its Aspire IT contract – the biggest in Europe – were outlined as being two areas of concern. As was the Home Office’s Emergency Services Network.

“The Home Office seemed to downplay the risks to the contract and its being caught unawares by the contractor does not reassure us that the Department is on top of the contract or this project. This could cost the taxpayer dear,” it said.

Comment:

It’s hard to argue with a comment on Hall’s piece by @JagPatel3 who suggests that some in Whitehall are as preoccupied with spin as with the efficient delivery of public services.

“… Government is preoccupied with presentation, manipulation of words and the dark art of spinning – instead of working on its programme of reform to deliver public services efficiently, to satisfy the wants, needs and expectations of the electorate.

“The political imperative of needing to put a positive slant on everything the Government does or will do, irrespective of whether it is true or not, is the reason why spin has become the centrepiece of this Government’s communications strategy.

“And because Government has got a monopoly on inside information (enabling it to maintain extremely tight control), it uses spin to divert attention away from the key issues that really matter to citizens …

“the eagerness with which senior Civil Servants have complied with their political masters’ desire to see policy announcements framed around presentation and spin, at the expense of substance, would explain why their skills set has been narrowed down to this single, dark art.”

The commentator also says that the “intense focus of attention on presentation alone has resulted in a massive gap opening up between the leadership and lower ranks of the Civil Service, who have to deal with the reality of delivering public services on the ground, on a day-to-day basis, which has in itself, led to alienation and disaffection”.

A good summary. Many ordinary civil servants are doing the hard work of delivering public services while a few of their masters are preoccupied with keeping what they do secret and justifying or defending all else that is published in National Audit Office reports, other third-party reports or leaked emails.

It’s hardly surprising the Cabinet Office is losing control of departments. Since Maude’s departure it doesn’t want control. It has become clear that it wants, in a hassle-free way, to continue with Sir Humphrey’s non-integrated approach to government.

The Cabinet Office is just another Whitehall department. Why would it want to be an “enforcer?”

Jerry Fishenden has resigned from the Cabinet Office‘s Privacy and Consumer Advisory Group after nearly six years. First he was its chairman and more recently co-chairman.

The Privacy and Consumer Advisory Group comprises privacy and security experts who give the government independent analysis and guidance on personal data and privacy initiatives by departments, agencies and other public sector bodies. This includes GOV.UK Verify.

The group’s advice has had the citizens’ interests in mind. But the group might have been seen by some Whitehall officials as having an open and frank “outsiders” culture.

Francis Maude, then Cabinet Office minister, helped to set up the group but he left in 2015 and none of his replacements has had a comparable willingness to challenge the civil service culture.

Maude welcomed the help of outsiders in trying to change the civil service. He tried to bring down the costs of Government IT and sought to stop unnecessary or failing projects and programmes. He also wanted to end the “oligopoly” of a handful of large IT suppliers. But Maude’s initiatives have had little continuing support among some Whitehall officials.

Fishenden said in a blog post this week that Maude had wanted the Privacy and Consumer Advisory Group to be a “critical friend” – a canary that could detect and help fix policy and technology issues before they were too far down the policy / Bill process.

“The idea was to try to avoid a repeat of previous fiascos, such as the Identity Card Act, where Whitehall generalists found themselves notably out of their depth on complex technical issues and left Ministers to pick up the pieces.”

He added that “since Francis Maude’s departure, there has been only one meeting” with subsequent Cabinet Office ministers.

“Without such backing, those officials who find the group’s expert reviews and analyses “challenging” have found it easier to ignore, attempting instead to smuggle their often half-baked proposals past Ministers without the benefit of the group’s independent assistance…

“Let’s just hope that after the election the value of the group will be rediscovered and government will breathe life back into the canary. Doing so would help realise Francis Maude’s original purpose – and bring significant benefits to us all, whether inside or outside of government.”

Comment

One of the Privacy and Consumer Group’s strengths has been its independent view of Government IT-related initiatives – which is probably the main reason it has been marginalised.

Fishenden’s departure is further confirmation that since Maude’s departure, the Cabinet Office – apart from the Government Digital Service – has settled back into the decades-old Whitehall culture of tinkering with the system while opposing radical change.

While Whitehall’s culture remains unreformable, central government will continue to lose the best IT people from the private sector. Some of these include the former Government Digital Service executive director Mike Bracken, Stephen Foreshew-Cain, who took over from Bracken, Janet Hughes, programme director of Verify, Andy Beale, GDS’s chief technology officer, Paul Maltby, GDS’s director of data and former Whitehall chief information officers Joe Harley, Steve Lamey, Andy Nelson and Mark Dearnley.

The unfortunate thing is that a few powerful career civil servants, including some permanent secretaries, will be delighted to lose such outsiders.

Jerry Fishenden is simply the latest casualty of a civil service tradition that puts the needs of the department before those of the citizen.

Like the Government Digital Service, the Crown Commercial Service was set up as a laudable attempt to cut the huge costs of running central government.

The Cabinet Office under Francis Maude set up the Crown Commercial Service [CCS] in 2014 to cut the costs of buying common products and services for Whitehall and the wider public sector including the NHS and police.

It has a mandate to buy commodity IT, other products and services and whatever can be bought in bulk. It has had some success – for example with negotiating lower prices for software licences needed across Whitehall. The skills and knowledge of its civil servants are well regarded.

But, like the Government Digital Service, CCS has had limited support from permanent secretaries and other senior officials who’d prefer to protect their autonomy.

It has also been hindered by unachievable promises of billions of pounds in savings. Even CCS’s own managers at the time regarded the Cabinet Office’s plans for huge savings as over-optimistic.

Yesterday [13 December 2016] the National Audit Office published a report that questioned whether CCS has paid its way, let alone cut public sector costs beyond what civil and public servants could have achieved without it.

CCS employed 790 full-time equivalent staff in 2015/16 and had operating costs in one year alone of £66.3m

This was the National Audit Office’s conclusion:

“CCS has not achieved value for money. The Cabinet Office underestimated the difficulty of implementing joint buying for government. With no business case or implementation plan CCS ran into difficulties. Net benefits have not been tracked so it cannot be shown that CCS has achieved more than the former Government Procurement Service would have.

“However, the strategic argument for joint buying remains strong and CCS is making significant changes to improve future services.”

Some of the NAO’s detailed findings:

The public sector spends £2.5bn directly with CCS – £8bn less than originally forecast.

The forecast of £3.3bn net benefits from the creation of CCS over the four years to 2017-18 are unlikely to materialise.

The National Audit Office says the actual net benefits of CCS to date are “unknown”.

The Cabinet Office did not track the overall benefits of creating CCS.

Most of the planned transfers of procurement staff from central departments and the wider public sector to CCS haven’t happened.

Where some of the workforce has transferred, some departments have rehired staff to replace those who transferred.

Departments continue to manage their own procurement teams, although they use CCS’s frameworks.

CCS was set up with the power to force central departments to use its bulk buying services. But that power wasn’t enforced.

The National Audit Office says it is “no longer clear whether CCS has a clear mandate that requires all departments to use it for direct buying… it no longer has a clear timetable or expectation that further departments will transfer staff or buying functions to CCS”.

It’s all a far cry from the expectations set by a Cabinet Office announcement in 2013 which said that CCS will “ensure maximum value for the taxpayer is extracted from every commercial relationship”.

“The new Crown Commercial Service will ensure a step change in our commercial capability, giving government a much tighter grip on all aspects of its commercial performance, from market engagement through to contract management.”

Comment

Why CCS has failed so far to make much difference to Whitehall’s costs is not clear. It seems to have been hit by a combination of poor management at the outset, a high turnover of senior officials and ludicrously high expectations, combined with a civil service reluctance in central departments and the wider public sector to cede control over procurement to CCS – even when it comes to common products and services.

The NAO report is a reminder of a fundamental flaw in the way government works: central departments can’t in practice be forced to do anything. They are a power unto themselves. The Cabinet Office has powers to mandate a change of practice and behaviour in central departments – to which Sir Humphrey can shrug his shoulders and change nothing

Even the Prime Minister is, in practice, powerless to force departments to do something they don’t want to do (except in the case of the miscarriage of justice that involved two Chinook pilots who were eventually cleared of gross negligence because the then defence secretary Liam Fox, through a series of manoeuvres, forced the MoD to set the finding aside).

The CCS may be doomed to failure unless the Cabinet Office rigorously enforces its mandate to make government departments use its buying services.

If the Cabinet Office does not enforce its power, Sir Humphrey will always protect his turf by arguing that the products and services his officials buy – including IT in general – are specific and are usually tailored to the department’s unique and complex needs.

Much to the relief of Sir Humphrey, Francis Maude, the battle-hardened enforcer at the Cabinet Office, has left the House of Commons. He has no comparable replacement.

Are all central initiatives aimed at making a real dent in the costs of running Whitehall now doomed to failure?

Sir Humphrey knows the answer to that; and he’s wearing a knowing grin.

In a report published yesterday (25 October 2016) the National Audit Office said it will shortly be undertaking a review of the Government Digital Service.

It will study GDS’s “achievements and the challenges it faces, looking in particular at whether the centre of government is supporting better use of technology and business transformation in government”.

With GDS’s help Defra’s Rural Payments Agency adopted an agile approach to paying subsidies but the two parties fell out and GDS stopped working on the programme.

The NAO’s report suggests that the Rural Payments Agency is glad to be rid of GDS.

“The GDS no longer has significant involvement in the Programme and the Rural Payments Agency told us it has not sought any further support.

“Its distance from the Programme has allowed the Department [DEFRA] to shift from a focus on agile and digital delivery to an approach that combines agile software development with programme management and governance arrangements with which the RPA is more familiar.”

Francis Maude, meanwhile, has warned that the work of GDS, which has helped to “stop the wrong things happening”, is being undermined, reports Public Finance.

Maude, who set up GDS in 2011, blamed mandarins who were trying to reassert their autonomy.

Maude said that developments such as controls on spending and improvements in service standard assessment processes do not happen spontaneously.

“You have to drive it centrally, and departments, separate ministries and separate agencies prize their autonomy and they will always want to take it back, and that is now happening.

“Just at the moment when the UK has just recently been ranked top in the world for digital government, we are beginning to unwind precisely the arrangements that had led to that and which were being copied in America and Australia and also some other countries as well,” said Maude.

“This is, for me, a pity – there is a sense these old structures in government, which are essentially about preserving the power of the mandarins, are being reasserted.”

He said there was a “continuing need for very strong central strategic leadership with the power backing it up to stop the wrong things happening.”

Tom Kibasi, director of the Institute for Public Policy Research, said any dismantling of GDS illustrated “government’s extraordinary propensity to self harm”.

He said it was very odd that GDS was being “scaled back and unwound at just the moment that it appears to be successful”.

In August 2016 Maude warned that it would be a “black day” if GDS were dismantled.

A clash of cultures between GDS and the Rural Payments Agency made it almost inevitable that the two sides would fall out. This is also what happened between GDS and the DWP.

Agile-wedded idealists?

If some senior civil servants had their way, particularly at the DWP, GDS would slowly lose its identity and its staff gradually dispersed throughout the civil and public services.

Clearly civil servants at the Rural Payments Agency looked at GDS as comprising mostly agile-wedded idealists obsessed with technological innovation rather than paying subsidies to farmers.

But long before the arrival of GDS, the RPA had a history of IT failure. Perhaps the RPA would rather be left on its own to fail without GDS’s help?

The latest NAO report is a little more positive about the RPA’s achievements than some past reports.

But this week’s Farmers Weekly, which has reported extensively on delays of correct subsidy payments to farmers, quoted the National Farmers Union as saying that problems from 2015 claims were still far from over.

The future of GDS?

How easy is it for senior officials in any large central department to work closely with the Government Digital Service?

Departments – particularly HMRC and the DWP – cherish their autonomy, so GDS is seen by some permanent secretaries as an unnecessary interference.

And when it comes to the IT of central departments, GDS has no clear role.

But GDS’s creation was a good idea. Without it, departments will be left alone to continue IT spending on a vast scale.

GDS’s admittedly brief challenge at the Rural Payments Agency and at the DWP on the Universal Credit IT programme has, arguably, slightly modernised IT approaches within those departments.

And even if the costs of big Whitehall IT contracts have not changed much, there’s no doubt that the public face of government IT has improved noticeably (eg using digital passport photos for online driving licence renewals),

The more its people are resented by high-ranking civil servants, the better job GDS is probably doing on behalf of the public.

Consensus can sometimes mean complacency. Long may GDS’s relationship with departments be characterised by a state of creative, noble tension.

The Wachter review of NHS technology was due to be published in June but has been delayed. Would it matter if it were delayed indefinitely?

A “Yes Minister” programme about a new hospital in North London said it all, perhaps. An enthusiastic NHS official shows the minister round a hospital staffed with 500 administrators. It has the latest technology on the wards.

“It’s one of the best run hospitals in the country,” the NHS official tells the minister, adding that it’s up for the Florence Nightingale award for the standards of hygiene.

“But it has no patients,” says the minister.

Another health official tells the minister,

“First of all, you have to sort out the smooth running of the hospital. Having patients around would be no help at all.” They would just be in the way, adds Sir Humphrey.

In the Wachter’s review’s terms of reference (“Making IT work: harnessing the power of health IT to improve care in England“) there is a final bullet point that refers, obliquely, to a need to consider patients. Could the Wachter terms of reference have been written by a satirist who wanted to show how it was possible to have a review of NHS IT for the benefit of suppliers, clinical administrators and officialdom but not patients?

The Wachter team will, according to the government,

• Review and articulate the factors impacting the successful adoption of health information systems in secondary and tertiary care in England, drawing relevant comparisons with the US experience;

• Provide a set of recommendations drawing on the key challenges, priorities and opportunities for the health and social care system in England. These recommendations will cover both the high levels features of implementations and the best ways in which to engage clinicians in the adoption and use of such systems.

In making recommendations, the board will consider the following points:

• The experiences of clinicians and Trust leadership teams in the planning, implementation and adoption of digital systems and standards;

• The current capacity and capability of Trusts in understanding and commissioning of health IT systems and workflow/process changes.

• The current experiences of a number of Trusts using different systems and at different points in the adoption lifecycle;

• The impact and potential of digital systems on clinical workflows and on the relationship between patients and their clinicians and carers.

Yes, there’s the mention of “patients” in the final bullet point.

Existing systems?

Some major IT companies have, for decades, lobbied – often successfully – for much more public investment in NHS technology. Arguably that is not the priority, which is to get existing systems to talk to each other – which would be for the direct benefit of patients whose records do not follow them wherever they are looked at or treated within the NHS.

Unless care and treatment is at a single hospital, the chances of medical records following a patient around different sites, even within the same locality, are slim.

Should a joining up of existing systems be the main single objective for NHS IT? One hospital consultant told me several years ago – and his comment is as relevant today –

“My daughter was under treatment from several consultants and I could never get a joined-up picture. I had to maintain a paper record myself just to get a joined-up picture of what was going on with her treatment.”

Typically one patient will have multiple sets of paper records. Within one hospital, different specialities will keep their own notes. Fall over and break your leg and you have a set of orthopaedic notes; have a baby and you will have a totally different set of notes. Those two sets are rarely joined up.

One clinician told me, “I have never heard a coroner say that a patient died because too much information was shared.”

And a technology specialist who has multiple health problems told me,

“I have different doctors in different places not knowing what each other is doing to me.”

As part of wider research into medical records, I asked a hospital consultant in a large city with three major hospitals whether records were shared at least locally.

“You must be joking. We have three acute hospitals. Three community intermediate teams are in the community. Their records are not joined. There is one private hospital provider. If you get admitted to [one] hospital and then get admitted to [another] the next week your electronic records cannot be seen by the first hospital. Then if you get admitted to the third hospital the week after, again not under any circumstances will your record be able to be viewed.”

Blood tests have to be repeated, as are x-rays; but despite these sorts of stories of a disjointed NHS, senior health officials, in the countless NHS IT reviews there have been over 30 years, will, it seems, still put the simplest ideas last.

It would not cost much – some estimate less than £100m – to provide secure access to existing medical records from wherever they need to be accessed.

No need for a massive investment in new technology. No need for a central patient database, or a central health record. Information can stay at its present location. Just bring local information together on local servers and provide secure access.

“If you are a member of the Armed Forces, your MO can get access to your (EMIS-based) medical record from anywhere in the world. There is no technical reason why the NHS cannot do this. If need be, the patient could be given a password to permit a GP to see another Surgery’s record.”

New appointments

To avoid having patients clog up super-efficient hospitals, Sir Humphrey would have the Wachter review respond to concerns about a lack of joined up care in the NHS by announcing a set of committees and suggesting the Department of Health and NHS England appoint a new set of senior technologists.

Which is just what has happened.

Last week NHS England announced “key appointments to help transform how the NHS uses technology and information”. [One of the NHS appointments is that of a Director of Digital Experience, which is not a fictional title, incidentally. Ironically it seems to be the most patient-facing of the new jobs.]

Said the announcement,

“The creation of these roles reflects recommendations in the forthcoming review on the future of NHS information systems by Dr Bob Wachter.

“Rather than appoint a single chief information and technology officer, consistent with the Wachter review the NHS is appointing a senior medical leader as NHS Chief Clinical Information Officer supported by an experienced health IT professional as NHS Chief Information Officer.

“The first NHS Chief Clinical Information Officer will be Professor Keith McNeil, a former transplant specialist who has also held many senior roles in healthcare management around the world, including Chief Executive Officer at Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust and Chief Executive Officer at the Royal Brisbane and Women’s Hospital in Australia.

“The new NHS Chief Information Officer will be Will Smart, currently Chief Information Officer at the Royal Free London NHS Foundation Trust. Mr Smart has had an extensive career in IT across the NHS and in the private sector.

“The NHS CCIO and NHS CIO post-holders will act on behalf of the whole NHS to provide strategic leadership, also chairing the National Information Board, and acting as commissioning ‘client’ for the relevant programmes being delivered by NHS Digital (previously known as the Health and Social Care Information Centre).

“The roles will be based at NHS England and will report to Matthew Swindells, National Director: Operations and Information, but the post-holders will also be accountable to NHS Improvement, with responsibility for its technology work with NHS providers.

“In addition, Juliet Bauer has been appointed as Director of Digital Experience at NHS England. She will oversee the transformation of the NHS Choices website and the development and adoption of digital technology for patient ‘supported self-management’, including for people living with long term conditions such as diabetes or asthma. Ms Bauer has led delivery of similar technology programmes in many sectors, including leading the move to take Times Newspapers online…”

Surely a first step, instead of arranging new appointments and committees, and finding ways of spending money on new technology, would be to put in place data sharing agreements between hospitals?

A former trust chief executive told me,

“In primary care, GPs will say the record is theirs. Hospital teams will say it is our information and patient representative groups will say it is about patients and it is their nformation. In maternity services there are patient-held records because it is deemed good practice that mums-to-be should be fully knowledgeable and fully participating in what is happening to them.

“Then you get into complications of Data Protection Act. Some people get very sensitive about sharing information across boundaries: social workers and local authority workers. If you are into long-term continuous care you need primary care, hospital care and social care. Without those being connected you may do half a job or even less than that potentially. There are risks you run if you don’t know the full information.”

He added that the Summary Care Record – a central database of every patient’s allergies, medication and any adverse reactions to drugs, was a “waste of time”.

“You need someone selecting information to go into it [the Summary Care Record]so it is liable to omissions and errors. You need an electronic patient record that has everything available but is searchable. You get quickly to what you want to know. That is important for that particular clinical decision.”

Is it the job of civil servants to make the simple sound complicated?

Years ago, a health minister invited me for an informal meeting at the House of Commons to show me, in confidence, a one-page civil service briefing paper on why it was not possible to use the internet for making patient information accessible anywhere.

The minister was incredulous and wanted my view. The civil service paper said that nobody owned the internet so it couldn’t be used for the transfer of patient records. If something went wrong, nobody could be blamed.

That banks around the world use the internet to provide secure access to individual bank accounts was not mentioned in the paper, nor the existence of the CHAPS network which, by July 2011, had processed one quadrillion (£1,000,000,000,000,000) pounds.

Did the briefing paper show that the civil service was frightened by the apparent simplicity of sharing patient information on a secure internet connection? If nothing else, the paper showed how health service officials will tend, instinctively, to shun the cheapest solutions. Which may help to explain how the (failed) £10n National Programe for IT came into being in 2002.

Jargon

Nobody will be surprised if the Wachter review team’s report is laden with jargon about “delays between technology being introduced and a corresponding rise in output”. It may talk of how new technology could reduce the length of stay by 0.1528 of a bed day per patient, saving a typical hospital £1.8m annually or 7,648 bed days.

It may refer to visions, envisioning fundamental change, establishing best practice as the norm, and a need for adaptive change.

It was written for the DWP by the Cabinet Office’s Major Projects Authority. Interviewees included Iain Duncan Smith and Lord Freud who was – and is – a work and pensions minister.

In 2012 Lord Freud signed off the DWP’s recommendation that an FOI request for the report’s release be refused.

Remarkable

The now-released report is remarkable for its professionalism and neutrality. It’s also remarkably ordinary given the number of words that have been crafted by the DWP’s lawyers to FOI tribunals and appeals in an effort to keep the report from being published.

The DWP’s main reason for concealing the report – and others that IT projects professional John Slater had requested under FOI in 2012 – was that publication could discourage civil servants from speaking candidly about project problems and risks, fearing negative publicity for the programme.

In the end the DWP released the report 11 days ago. This was probably because the new work and pensions secretary Stephen Crabb refused to agree the costs of a further appeal. Last month an FOI tribunal ordered that the project assessment review, risk register and issues register be published.

Had the reports been published at the time of the FOI request in 2012 it might have restricted what ministers and the DWP’s press office were able to say publicly about the success so far of the Universal Credit programme.

In the absence of their publication, the DWP issued repeated statements that dismissed criticisms of its programme management. Ministers and DWP officials were able to say to journalists and MPs that the Universal Credit programme was progressing to time and to budget.

In fact the project assessment review questioned a projected increase of £25m of IT spend in the budget.

MPRG is the Major Projects Review Group, part of the Cabinet Office. OBC is the Outline Business Case for Universal Credit. SOBC is the Strategic Outline Business Case.

The DWP claimed in the report that the projected of £25m in IT spend was a “profiling”rather than budgetary issue.

By this the DWP meant that it planned to boost significantly the projected savings in later years of the project. Those anticipated savings would have offset the extra IT spend in the early years. Hence the projected overspend was a “profiling” issue.

But the report questioned the credibility of the profiling exercise.

On the question of whether the whole programme could be afforded the report had mixed views.

The report was largely positive about the DWP’s work on Universal Credit. It also revealed that in some ways not all was progressing as well as had been hoped (which was contrary to DWP statements at the time). The report said,

And a further mention of “behind the curve”…

None of these problems was even hinted at in official DWP statements in 2012. About six months after the project assessment review was conducted, this was a statement by a DWP minister (who uses words that were probably drafted by civil servants).

“The development of Universal Credit is progressing extremely well. By next April we will be ready to test the end to end service and use the feedback we get from claimants to make final improvements before the national launch.

“This will ensure that we have a robust and reliable new service for people to make a claim when Universal Credit goes live nationally in October 2013.”

And the following is a statement by the then DWP secretary of state Iain Duncan Smith in November 2011, which was around the time the project assessment review was carried out. Doubtless his comments were based on briefings he received from officials.

“The [Universal Credit] programme is on track and on time for implementing from 2013.

“We are already testing out the process on single and couple claimants, with stage one and two now complete. Stage 3 is starting ahead of time – to see how it works for families.

“And today we have set out our migration plans which will see nearly twelve million working age benefit claimants migrate onto the new benefits system by 2017.”

Ironic

It’s ironic that the DWP spent four years concealing a report that could have drawn attention to the need for better communications.

The report highlighted the need for three types of communication, internal, external and with stakeholders.

It’s true the reports are nearly four years old. They are not out of date.

They could hardly be more important if they highlight a fundamental democratic flaw, a flaw that allows Whitehall officials and ministers to make positive public statements about a huge government project while hiding reports that could contradict those statements or could put their comments into an enlightening context.

Stephen Crabb, IDS’s replacement at the DWP, is said by the Sunday Times to want officials to come clean to him and the public about problems on the Universal Credit programme.

To do that his officials will have to set themselves against a culture of secrecy that dates back decades. Though not as far as the early 1940s.

Official proceedings of parliament show how remarkably open were statements made to the House during WW2. It’s odd that Churchill, when the country’s future was in doubt, was far more open with Parliament about problems with the war effort than the DWP has ever been with MPs over the problems on Universal Credit.

I have said it before but it’s time for Whitehall departments, particularly the DWP, to publish routinely and contemporaneously their project assessment reviews, issues registers and risk registers.

Perhaps then the public, media and MPs will be better able to trust official statements on the current state of multi-billion pound IT-based programmes; and a glaring democratic deficit would be eliminated.

Openness may even help to improve the government’s record on managing IT.

The Freedom of Information Commission reported comprehensively yesterday on the workings of the FOI Act. It raised the question of whether risk registers and Major Project Authority project assessment reviews should be published.

The Commission’s members, who included former Tory leader Michael Howard and Labour’s Jack Straw, received over 30,000 responses to their call for evidence. They met numerous stakeholders, heard ten hours of oral evidence and produced an impressive report that opposed the idea of charging for FOI requests.

Two of the seven Cabinet vetoes have been on FOI requests related to risk assessments. Indeed the Department for Work and Pensions is fighting a protracted legal battle (three years so far) to stop three reports on the Universal Credit IT programme being published, including a risk register and project assessment review.

Is there any good reason not to publish a risk register, or a project assessment review? Aren’t the public entitled to know the extent to which their money is at risk on a project or programme?

No, argue civil servants, whose views on confidentiality are almost always supported by their ministers. Civil servants contend that they need a “safe space” to be imaginatively negative, to think the unthinkable, without the media and opposition MPs seizing on a risk register as evidence that an innovative scheme should not get off the ground.

Civil servants and ministers argue that disclosing risk registers (and project assessment reviews) would mean that those who contribute to them would tone down or sanitise their comments. Civil servants would not be completely honest or candid when setting out the scale or magnitude of the risks.

This is what the FOI Commission concluded:

Risk assessments

“In our call for evidence we described risk assessments as a particularly relevant example of the tension between the public’s right to know, and the need for public bodies to have an internal deliberative space.

Many documents will contain mention of risks, but here we are concerned principally with documents that are explicitly devoted to setting out a candid risk assessment. We drew particular attention to risk assessments because two of the seven Cabinet vetoes have been in respect of risk assessments.

The most obvious example of a candid risk assessment is the ‘risk register’. Project management processes typically utilise risk registers as part of their methodology. Risks are normally given a rating on a scale of 1 to 5 of the likelihood of the risk occurring (where 5 is the highest likelihood of the risk occurring) and the scale of the impact if that risk occurred. Using the scores for likelihood and impact, a “Red / Amber / Green” (RAG) rating is created denoting how serious a risk is.

Risk registers do not generally provide detailed explanations of the risks involved, but only the headline risk and potential mitigation.

The Office of Government Commerce (OGC) Gateway Review is another example of a risk assessment. Gateway Reviews examine programmes and projects at key decision points using a peer review process in which independent practitioners examine progress and likelihood of successful delivery. These reviews can apply to e.g. IT or procurement processes, but can also apply to policy development.

Policy impact assessments are formal evidence based procedures that assess the economic, social and environmental costs and risks and benefits of a policy. These are published for example: at the same time as a consultation, response to consultation or at introduction of a Bill or as part of any change during the passage of the Bill.

Major Project Authority Project Assessment Reviews (PARs) are detailed assessments of large projects. They are more tailored to specific projects than Gateway Reviews. Following frank interviews with staff they culminate in a report for the Senior Risk Owner for the project setting out recommendations and assessment of risks.

In its response to the call for evidence Kent County Council highlighted the difficulties that could arise if candid risk assessments were made routinely available:

‘…it could mean that people do not feel confident enough to put risks they have identified onto the registers, or that risk registers themselves are not compiled in the first place for fear of repercussions. This could lead to potential “nasty surprises” and poor decision-making if people choose to keep risks ‘in their heads’ (paragraph 3.3)

By contrast, in their evidence the Open Government Network said:

‘The public acknowledgement of the existence of certain risks will enhance the public debate about major projects and their implementation. It is when risks can be silently ignored that the consequences are dramatic, often then requiring the complete publication of a flawed risk register when it is too late to prevent the overlooked problems.’

The Commission agrees with the evidence of the IC [Information Commissioner] in which he says that the impact of disclosing candid risk assessments can vary depending on the sensitivity of the topic and what is already in the public domain.

There will be risk assessments where it is so keenly in the public interest that the risks identified be disclosed (for example, where these concern serious risks to public health or life) that, notwithstanding the need for these assessments to be part of an internal deliberative process, they should be disclosed.

In other cases the nature and candour of the risks may mean that they should not be published. The Commission has reached that the conclusion that the public interest test provides the best way to assess whether specific risk assessments should be published, and that no additional or specific protection is required for risk assessments.”

Comment

There are times when civil servants and ministers take themselves and what they do too seriously. The continuing confidentiality of risk registers is an example.

NHS trusts routinely publish risk registers in their board papers and nobody notices, not even the local press, because risk registers highlight things that haven’t happened, but may happen.

Even a high-risk score is an esoteric and speculative concept that is unlikely to interest the general public. So risk registers in the NHS go unreported.

Central government, on the other hand, generally protects risk registers as if they are new-born babies.

Civil servants fear the media would have a field day if risk registers were routinely disclosed.

In fact they would go largely unreported. Journalism tends to be about things that are happening, and have happened, rather than risks that may materialise if certain circumstances come together.

Few journalists will convince their news editor of a potential story about a project or programme that has a high risk assessment score.

Instinct will tell civil servants and bureaucracies to prefer confidentiality to openness. Secrecy reduces the pressure for accountability. It minimises the risk of dissent.

I have the impression that some civil servants – perhaps mainly in the Department for Work and Pensions – would lie down in front of a bulldozer rather than allow it to break down the barriers of confidentiality over risk assessments.

But there is no sound reason for keeping risk registers and project assessment reviews confidential. The public is entitled to know when tax money is at risk.

Civil servants and ministers often forget when are locking away risk assessment reports that they are locking out the public that pays their salaries, and is paying for the projects and programmes where the risks are being kept secret.

Government secrecy is an inevitable part of life in North Korea and China. Should it be inevitable in Whitehall?

Thank you to Government Computing for drawing my attention to the risk registers section of the FOI Commission’s report.

Thanks also to FOI campaigner Dave Orr who pointed out that the FOI Commission’s report quotes Maurice Frankel of the Campaign for Freedom of Information who says: “We now need to ensure that the Act is extended to contractors providing public services…”

It’s extraordinary that some of the Department for Work and Pensions’ main arguments against publishing three reports on the Universal Credit programme resemble, in part, those given by the Walpole government of 1738 when the House of Commons passed a resolution against the publishing of Parliamentary debates.

The DWP argues that the media could misinterpret the three Universal Credit reports or take negative comments in them out of context, which would have a “chilling effect” on the officials who contribute to or write the reports.

In the 17th and 18th centuries, members of the House of Commons and House of Lords were concerned that parliament could be brought into disrepute by the irresponsible reporting of its proceedings, and that MPs could be influenced in what they said in debates by the knowledge that their speeches could be reported .

Sir Robert Walpole, the then prime minister, in winding up an 1738 debate on banning newspaper reporting of Parliament, said press coverage of parliamentary proceedings was a “forgery of the worst kind”.

Neither officials nor ministers had at that time invented the phrase “chilling effect” but they held to its meaning: they expressed concern that if debates were in the public domain members would shape what they said in debates to win influence, or avoid criticism by, newspapers.

Eventually Parliament decided in the 19th century that it was in its own interests to have debates in the public domain partly because important speeches were going unreported.

Today the DWP is a long way from reaching the stage of openness of Parliament in the 18th century.

After hearing the DWP’s evidence in the case of the three Universal Credit reports, an FOI tribunal judge sympathised with the department. He (Judge Edward Jacobs) said, “It is not difficult, looking at the Risk Register (one of the three Universal Credit reports in question), to see how a journalist or blogger with an agenda could select and present parts of the material in a way that would generate attention and attract criticism of the Department (DWP).”

Still referring to the media, he said, “There is no limit to the ways in which seemingly innocuous details can be used as a means of causing trouble.”

The judge’s apparent sympathy for the DWP’s case surprised me, given that Parliament decided centuries ago that the risk of MPs being influenced by the media when making speeches was a minor consideration when weighed against the importance of reporting the proceedings of parliament.

Democracy is far from perfect but it is surely not served by departments such as the DWP keeping secret for as long as they can reports on their performance on high-cost, risky and innovative programmes such as Universal Credit.

The National Audit Office will usually report on programmes as big as Universal Credit, and will usually do so with skill, insight and professionalism. But it didn’t report on the UC programme until September 2013.

Disclosure of the risk and issues registers and project assessment review when they were requested under FOI would have given MPs, the public and stakeholders the chance to hold ministers and officials to account in 2012 – at a time when Iain Duncan Smith and senior officials at the DWP were confidently claiming that the UC programme was on time and to budget. IDS said nothing in 2012 about the problems the programme was facing.

“High indignity”

It’s fascinating to look back at debates of the House of Commons in the 17th and 18th centuries to see how closely some of the speeches resemble the arguments the DWP is making in its submissions to next week’s FOI tribunal.

In April 1738 the Commons passed a resolution declaring that it was a “high indignity and a notorious breach of privilege” to report what was said in the Chamber, even when it was in recess.

This was the 1738 resolution:

“That it is an high indignity to, and a notorious breach of privilege of, this House, for any News writer, in letters, or other papers (as Minutes or under any other denomination) or for any printer or publisher of any printed newspaper, of any denomination, to presume to infer in the said letters or papers, or to give therein, any account of the debates, or other proceedings of this House, or any Committee thereof, as well during the recess, as the sitting of Parliament; and that this House will proceed with the utmost severity against such offenders.”

Part of the DWP’s case to the FOI tribunal next week in Leicester is that, if the reports in question are published, they could be misinterpreted by the public, which would involve ministers and civil servants being diverted from the Universal Credit programme to correct the media.

It may be worth noting some of the actions taken by the House of Commons in 1771 against newspaper proprietors who published proceedings of the Commons – and allegedly got it wrong.

The Gazetteer and New Daily Advertiser on Friday 8 February 8 1771, which was printed for R. Thomson, and also the Middlesex Journal on Tuesday 5 February 5 to Thursday 7 February 1771, which was printed for J Weeble, were accused of “misrepresenting the speeches, and reflecting on several of the members of this House, in contempt of the order, and in breach of the privilege of this House”.

The House issued a proclamation for the apprehension of John Weeble and R Thompson.

Today the DWP seems not to accept that being held to account by journalists, even incompetent and hostile ones, is a price to be paid for democracy.

Accountability

Parliament banned newspaper reports of its debates in the 17th and 18th centuries in part because publication would have meant contemporaneous accountability.

That, it seems to me, is the main reason the DWP opposes disclosure of any independent and authoritative reports on its performance on the UC programme.

Senior officials are understandably concerned about personal and contemporaneous accountability on a big, risky, high-cost IT-enabled programme. Not the IT professionals who, incidentally, are largely in favour of openness.

Middle-ranking managers on the UC programme have a tough time of it. They rarely get any credit for what they achieve. But there is a notable divide between the cultures of middle and senior management.

Now that the House of Commons allows reporting of its proceedings, and even allows TV cameras, the DWP’s ministers and senior officials look as if they are stuck in a bygone era. They believe that the public can wait for accountability until the National Audit Office decides to publish its reports.

But how well can the public hold the DWP to account if people doesn’t know how hundreds of millions of pounds are being spent – at the time it is spent – on the Universal Credit IT programme?

The high turnover of senior management on big programmes all but ensures that the most senior officials will probably have moved on by the time the National Audit Office reports on their programmes.

No bureaucracy will embrace openness until it is forced to. Nobody should be surprised that the DWP is fighting the publication of the disputed UC reports.

Kicking and screaming

What’s needed, therefore, is a campaigning minister, to bring today’s top officials at the DWP kicking and screaming into the modern world.

There is a serious consequence to the DWP’s antiquated approach to openness: the mounting legal costs of the FOI case it keeps appealing.

Officials and ministers at the DWP are launching FOI appeals as if money were no object. Bundles of documents have been produced by barristers and other lawyers who have been working on behalf of the DWP.

I don’t believe senior officials care particularly what is in the reports.

They are really fighting, perhaps subconsciously, to continue their control of official information on the UC programme.

For that privilege they will continue to dig deeply into the public purse for the legal costs of this case. That’s a scandalous waste of money, especially in a supposed era of open government.